EFFECT OF THE KOBE EARTHQUAKE ON STRESS AND GLYCEMIC CONTROL IN PATIENTS WITH DIABETES-MELLITUS

Objectives: To examine the effects oi the Kobe.Japan, earthquake a lif e-threatening event, on stress and glycemic control in diabetic patien ts. Patients and Methods: Hemoglobin A(1c) levels before and alter the earthquake were evaluated in diabetic patients in Kobe (N=157; magnit ude, 7.2) and in Osaka, Japan. as a control (N=277; magnitude, 4.2),wh ere little damage to houses and traffic facilities occurred. Glycosyla ted hemoglobin levels were also compared with those of 2 years before and 1 year after the earthquake. The General Health Questionnaire (GHQ ) and a self-administered questionnaire regarding damage to houses and relatives killed or injured were used to assess psychological and men tal stresses on earthquake survivors. Results: Glycemic control was ag gravated in diabetic patients after the earthquake in Kobe but not in Osaka. The GHQ scores were significantly higher in the patients in Kob e than those in Osaka. Increased hemoglobin A(1c) concentrations and h igh scores on the GHQ were especially evident in diabetic patients wit h severe damage to houses and/or with relatives killed or injured. Con clusions: These results suggest an association between chronic, life-t hreatening stress and the worsening of metabolic control in patients w ith diabetes mellitus.